<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('商户')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-yee_id" data-rule="required" data-source="yeemanage/yee/index" data-field="signName" class="form-control selectpage" name="row[yee_id]" type="text" value="">
        </div>
    </div>
     <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('姓名')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-signName" class="form-control" name="row[signName]" type="text">
        </div>
    </div>

    <!--<div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('店铺编号')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-store_no" class="form-control" name="row[store_no]" type="text">
        </div>
    </div>-->
    <!--<div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Requestno')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-requestNo" class="form-control" name="row[requestNo]" type="text">
        </div>
    </div>-->
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Businessrole')}:</label>
        <div class="col-xs-12 col-sm-8">
                        
            <select  id="c-businessRole" class="form-control selectpicker" name="row[businessRole]">
                {foreach name="businessroleList" item="vo"}
                    <option value="{$key}" {in name="key" value=""}selected{/in}>{$vo}</option>
                {/foreach}
            </select>

        </div>
    </div>
     <div class="form-group">
      <label class="control-label col-xs-12 col-sm-2">{:__('省市区')}:</label>
      <div class="col-xs-12 col-sm-8">
          <div class="form-inline" data-toggle="cxselect" data-selects="province,city,district">
              <select class="province form-control" name="row[province]" data-url="ajax/yeearea"></select>
              <select class="city form-control" name="row[city]" data-query-name="province" data-url="ajax/yeearea"></select>
              <select class="district form-control" name="row[district]" data-query-name="city" data-url="ajax/yeearea"></select>
          </div>
      </div>
 </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('地址')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-address" class="form-control" name="row[address]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Legalname')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-legalName" class="form-control" name="row[legalName]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Legallicencetype')}:</label>
        <div class="col-xs-12 col-sm-8">
                        
            <select  id="c-legalLicenceType" class="form-control selectpicker" name="row[legalLicenceType]">
                {foreach name="legallicencetypeList" item="vo"}
                    <option value="{$key}" {in name="key" value=""}selected{/in}>{$vo}</option>
                {/foreach}
            </select>

        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Legallicenceno')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-legalLicenceNo" class="form-control" name="row[legalLicenceNo]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Legallicencefronturlimage')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-legalLicenceFrontUrlimage" class="form-control" size="50" name="row[legalLicenceFrontUrlimage]" type="text">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="faupload-legalLicenceFrontUrlimage" class="btn btn-danger faupload" data-url="ajax/yeeupload" data-input-id="c-legalLicenceFrontUrlimage" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp" data-multiple="false" data-preview-id="p-legalLicenceFrontUrlimage"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-legalLicenceFrontUrlimage" class="btn btn-primary fachoose" data-input-id="c-legalLicenceFrontUrlimage" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-legalLicenceFrontUrlimage"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-legalLicenceFrontUrlimage"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Legallicencebackurlimage')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-legalLicenceBackUrlimage" data-rule="required" class="form-control" size="50" name="row[legalLicenceBackUrlimage]" type="text">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="faupload-legalLicenceBackUrlimage" class="btn btn-danger faupload" data-url="ajax/yeeupload" data-input-id="c-legalLicenceBackUrlimage" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp" data-multiple="false" data-preview-id="p-legalLicenceBackUrlimage"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-legalLicenceBackUrlimage" class="btn btn-primary fachoose" data-input-id="c-legalLicenceBackUrlimage" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-legalLicenceBackUrlimage"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-legalLicenceBackUrlimage"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Mobile')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-mobile" class="form-control" name="row[mobile]" type="text">
        </div>
    </div>
 <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bankaccounttype')}:</label>
        <div class="col-xs-12 col-sm-8">
                        
            <select  id="c-bankAccountType" class="form-control selectpicker" name="row[bankAccountType]">
                {foreach name="bankaccounttypeList" item="vo"}
                    <option value="{$key}" {in name="key" value=""}selected{/in}>{$vo}</option>
                {/foreach}
            </select>

        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bankcardno')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bankCardNo" class="form-control" name="row[bankCardNo]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bankcode')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bankCode" class="form-control" name="row[bankCode]" type="text">
        </div>
    </div>
    <!--<div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Merchantno')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-merchantNo" class="form-control" name="row[merchantNo]" type="text">
        </div>
    </div>-->
    <!--<div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Applicationstatus')}:</label>
        <div class="col-xs-12 col-sm-8">
            
            <div class="radio">
            {foreach name="applicationstatusList" item="vo"}
            <label for="row[applicationStatus]-{$key}"><input id="row[applicationStatus]-{$key}" name="row[applicationStatus]" type="radio" value="{$key}" {in name="key" value="COMPLETED"}checked{/in} /> {$vo}</label> 
            {/foreach}
            </div>

        </div>
    </div>-->
    <!--<div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Applicationno')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-applicationNo" class="form-control" name="row[applicationNo]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Businessplacephotourlimage')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-businessPlacePhotoUrlimage" data-rule="required" class="form-control" size="50" name="row[businessPlacePhotoUrlimage]" type="text">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="faupload-businessPlacePhotoUrlimage" class="btn btn-danger faupload" data-input-id="c-businessPlacePhotoUrlimage" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp" data-multiple="false" data-preview-id="p-businessPlacePhotoUrlimage"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-businessPlacePhotoUrlimage" class="btn btn-primary fachoose" data-input-id="c-businessPlacePhotoUrlimage" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-businessPlacePhotoUrlimage"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-businessPlacePhotoUrlimage"></ul>
        </div>
    </div>-->
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
